Pedron Sara, Schmaderer Katharina, Murawski Monika, Schwettmann Lars
Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; German Center for Diabetes Research, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany; Pettenkofer School of Public Health, Munich, Germany.
Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany.
Soc Sci Res. 2021 Mar;95:102521. doi: 10.1016/j.ssresearch.2020.102521. Epub 2020 Dec 30.
The socioeconomic environment in childhood is a powerful determinant for health behavior in adulthood, subsequently influencing health outcomes. However, the underlying mechanisms are insufficiently understood. This study assesses locus of control (LOC) as a mediator linking childhood socioeconomic status (SES) with health behavior (smoking, regular alcohol consumption, unhealthy diet and low physical activity). Drawing on a representative sample from Germany (SOEP), we investigated these relations using structural equations modelling. Results show that externally oriented LOC explains up to 6% of the relationship between childhood SES and health behavior in adulthood, independently from adult SES. Stratification indicates that these results hold in women but not in men, in younger and middle-aged individuals but not in older ones. Hence, control beliefs play a modest yet significant role in shaping the socioeconomic gradient in health behavior and might have far-reaching consequences on how morbidity and mortality arise and persist across generations.
童年时期的社会经济环境是成年后健康行为的一个有力决定因素，进而影响健康结果。然而，其潜在机制尚未得到充分理解。本研究评估了控制点（LOC）作为一种中介因素，将童年社会经济地位（SES）与健康行为（吸烟、经常饮酒、不健康饮食和低体力活动）联系起来。利用来自德国的代表性样本（社会经济面板研究，SOEP），我们使用结构方程模型研究了这些关系。结果表明，外部导向的控制点解释了童年SES与成年后健康行为之间高达6%的关系，且独立于成年SES。分层分析表明，这些结果在女性中成立，但在男性中不成立；在年轻和中年个体中成立，但在老年个体中不成立。因此，控制信念在塑造健康行为的社会经济梯度方面发挥着适度但重要的作用，并且可能对发病率和死亡率如何在代际间产生和持续存在产生深远影响。
